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Background The rising burden of pediatric allergic diseases underscores parental intentions and behaviors as critical to allergic prevention and management. This study aims to develop and validate a Protection Motivation Theory (PMT) based scale for parents of children with allergic diseases, and to examine the associations between parental protection motivation, their management intentions and behaviors, and pediatric health outcomes. Methods We conducted a cross-sectional study among parents of children with allergic diseases at Hangzhou Children’s Hospital, Zhejiang Province, China, from July to December 2022. The PMT scale was developed using data from a pilot survey ( N  = 440) and validated in an empirical study ( N  = 443). Structural equation modeling mapped interconnections between parental protective motivation, intention, and behavior. Multiple linear regression explored PMT dimensions’ association with parental intentions and behaviors, while machine learning models evaluated their clinical relevance to children’s disease outcomes. Results The PMT scale demonstrated good reliability (Cronbach’s α coefficient = 0.844) and validity (χ 2 /df = 2.918, RMSEA = 0.066, GFI = 0.906, CFI = 0.937, NFI = 0.908, IFI = 0.937, TLI = 0.919). In structural equation model, protection motivation showed significant overall interconnections with parental intention (0.78, p  < 0.001). PMT dimensions were associated to 48.2% and 45.5% of the variance in parental intention and behavior related to allergic diseases in multiple linear regressions, with self-efficacy and perceived susceptibility being the most strongly associated factors. Random forest models demonstrated good discrimination in identifying associations between PMT dimensions and children’s atopic severity and attacks, achieving AUC of 0.84 and 0.88 respectively, with all six PMT dimensions among the top-15 related variables. Conclusions Our findings reveal the relevance of measuring parental protective motivation as captured by the developed PMT scale. It had significant associations with key parental intentions and behaviors in managing childhood atopy. This implies the necessity of refined PMT-based interventions to support outcomes in childhood allergic disease management.

Research confirms that the mental health burdens following community-wide disasters are extensive, with pervasive impacts noted in individuals and families. It is clear that child disaster outcomes are worst among children of highly distressed caregivers, or those caregivers who experience their own negative mental health outcomes from the disaster. The current study used path analysis to examine concurrent patterns of parents’ (n = 420) experience from a national sample during the early months of the U.S. COVID-19 pandemic. The results of a multi-group path analysis, organized by parent gender, indicate good fit to the data [X2(10) = 159.04, p < .01]. Results indicate significant linkages between parents’ caregiver burden, mental health, and perceptions of children’s stress; these in turn are significantly linked to child-parent closeness and conflict, indicating possible spillover effects for depressed parents and compensatory effects for anxious parents. The impact of millions of families sheltering in place during the COVID-19 pandemic for an undefined period of time may lead to unprecedented impacts on individuals’ mental health with unknown impacts on child-parent relationships. These impacts may be heightened for families whose caregivers experience increased mental health symptoms, as was the case for fathers in the current sample.

This white paper provides a summary of a scientific proposal presented at a Cardiac Safety Research Consortium/Health and Environmental Sciences Institute/Food and Drug Administration–sponsored Think Tank, held at Food and Drug Administration's White Oak facilities, Silver Spring, MD, on July 23, 2013, with the intention of moving toward consensus on defining a new paradigm in the field of cardiac safety in which proarrhythmic risk would be primarily assessed using nonclinical in vitro human models based on solid mechanistic considerations of torsades de pointes proarrhythmia. This new paradigm would shift the emphasis from the present approach that strongly relies on QTc prolongation (a surrogate marker of proarrhythmia) and could obviate the clinical Thorough QT study during later drug development. These discussions represent current thinking and suggestions for furthering our knowledge and understanding of the public health case for adopting a new, integrated nonclinical in vitro/in silico paradigm, the Comprehensive In Vitro Proarrhythmia Assay, for the assessment of a candidate drug's proarrhythmic liability, and for developing a public-private collaborative program to characterize the data content, quality, and approaches required to assess proarrhythmic risk in the absence of a Thorough QT study. This paper seeks to encourage multistakeholder input regarding this initiative and does not represent regulatory guidance.

Purpose Insulin resistance (IR) is an important mediator of the relationship between food intake and the development of type 2 diabetes mellitus (T2DM). Most of the few studies that have evaluated this relationship relied on the triglyceride-glucose index (TyG index) tool. Here, we evaluated the association between leucine intake, glycemic index, and T2DM with related mediators in individuals throughout secondary cardiovascular prevention. Methods Sociodemographic, anthropometric, clinical, and food intake data were recorded from the baseline of the trial Brazilian Cardioprotective Nutritional (BALANCE) Program. Path analysis was used to explore the relationships between variables. Results This study enrolled 2,247 participants (median age of 63.0 (45–91) years; 58.8% males). The TyG index showed positive association with T2DM (SC = 0.356; p  < 0.001) and negative association with leucine intake (SC= -0.046; p  = 0.028). The glycemic index (GI) was positively associated with BMI (SC = 0.072; p  = 0.001), and BMI had an indirect positive effect on T2DM mediated by the TyG index (SC = 0.078; p  < 0.001). Leucine intake had indirect negative effect on T2DM, mediated by the TyG index (SC= -0.016; p  = 0.029), while GI had indirect positive effect on T2DM mediated by BMI and TyG index (SC = 0.006; p  = 0.002). Conclusion Leucine intake and GI showed indirect association with T2DM, mediated by TyG and BMI, in individuals on secondary cardiology prevention, reinforcing the importance of assessing food consumption and promotin food quality improvements for cardiometabolic control by different pathways. Trial registration clinicaltrials.gov identifier : NCT01620398. Registered 15 June 2012.

Since human beings have a long tradition of coexistence with pandemics, which may profoundly impact them, adopting preventive measures is crucial for humankind’s survival. This study explores the intention-based critical factors affecting the willingness of individuals to adopt pandemic prevention. To this end, a representative sample of 931 Pakistanis filled in an online questionnaire. However, only 828 questionnaires were found to be complete and valid for path modeling analysis. The core findings are as follows: Firstly, peer groups’ beliefs, self-efficacy, perceived risk, pandemic knowledge, ease of pandemic prevention adoption, and risk-averse behavior are revealed as driving forces of the individuals’ willingness to adopt pandemic prevention. Contrastingly, a lack of trust in political will and mythical attitude towards pandemics are uncovered as inhibitors. Nevertheless, moral values depict a neutral role. Secondly, the peer groups’ beliefs are highest ranked, followed by the lack of trust in political will and a mythical attitude towards pandemic prevention. Finally, moral values are determined as the lowest-ranked critical factor. Based on these results, the government should promote awareness campaigns on lethality and fatality of the pandemic at both centralized and decentralized levels to win people’s trust at the grass-roots level and overcome the mythical attitude of individuals at all societal levels. Besides, access to personal protective gears should be made feasible since an easier pandemic prevention adoption would increase the individuals’ willingness to adopt such preventative measures.

Social media use is associated with body image concerns, disordered eating and body change behaviors in adolescents. This study aimed to examine these relationships within a biopsychosocial framework and test an integrated model. A sample of 681 adolescents (49% female), mean age = 12.76 years (SD = 0.74), completed a questionnaire assessing social media use, depression, self-esteem, body mass index, social media and muscular ideal internalization, appearance comparison, body dissatisfaction, disordered eating, and muscle-building behaviors. Path analysis was used to test the hypothetical model, which after modification revealed good fit to the data, although gender differences emerged. The findings suggest that biopsychosocial frameworks are useful for conceptualizing relationships between social media use and body image, eating, and muscle building outcomes.

Abstract Healthcare providers who use controlling or coercive strategies may compel short-term enactment of HIV and sexually transmitted infection prevention behaviors but may inadvertently undermine their client’s motivation to maintain those behaviors in the absence of external pressure. Autonomous motivation refers to the self-emanating and self-determined drive for engaging in health behaviors. It is associated with long-term maintenance of health behaviors. We used structural equation modeling to investigate whether autonomy support was associated with increased odds of therapeutic serum levels of pre-exposure prophylaxis, through a pathway that satisfies basic psychological needs for autonomous self-regulation and competence regarding pre-exposure prophylaxis use. We also investigated whether autonomy support was associated with decreased odds of condomless anal intercourse via the same psychological needs-satisfaction pathway of autonomous self-regulation and competence regarding condom use. We tested these two theorized pathways using secondary data from a longitudinal sample of Black men who have sex with men from across three cities in the US (N = 226). Data from the sample fit the theorized models regarding the pathways by which autonomy support leads to the presence of therapeutic PrEP levels in serum (χ2 = 0.56; RMSEA = 0.04; CFI = .99, TLI = 0.98) and how it also leads to decreased odds of condomless anal intercourse (χ2 = 0.58; RMSEA = 0.03; CFI = 0.99; TLI = 0.98). These findings provide scientific evidence for the utility of self-determination theory as a model to guide intervention approaches to optimize the implementation and impact of PrEP for Black men who have sex with men.

•Sudden cardiac death in the young (SCDY) occurs regardless of age, ethnicity, race, sex, or socioeconomic status.•Athletes and nonathletes alike can have sudden cardiac death.•Primary prevention (screening) only in athletes and only with history and physical exam is insufficient.•Secondary prevention (AEDs and CPR training) is effective and should be implemented for all children. Sudden cardiac arrest and death in the young is a critical public health issue. It occurs in children of any age, sex, racial or ethnic demographic, or socioeconomic status. Importantly, it can affect any individual—athlete and nonathlete alike. Prevention of sudden death in the young is of high importance not only because of the loss of a young life but also because of the substantial impact to families and to society at large. This White Paper summarizes the proceedings of a third national Think Tank on prevention of sudden cardiac death in the young. The Think Tank, which convened on January 11 to 12, 2024 at Duke University in Durham, NC, was organized and conducted by the Cardiac Safety Research Consortium in collaboration with a broad panel of US and international stakeholders including representatives from the United States Food and Drug Administration, medicine, academia, industry, the military, parents and sudden cardiac arrest/death prevention advocates, and the public. Primary and secondary prevention of sudden cardiac death in youth were discussed in depth with a goal of developing consensus on uniform approaches which could be applied nationally.

Applying health behaviour change models, such as the theory of planned behaviour (TPB), to help-seeking for mental health problems can address the deficit in health care utilisation. However, previous studies largely focused on help-seeking intentions and not behaviour, which might be problematic due to the intention-behaviour gap. Hence, TPB and help-seeking were examined in a German community sample with current untreated depressive symptoms: 188 adults (Mage = 50.34; SD = 16.19; 70.7% female) participated in a baseline interview and survey measuring components of the TPB (attitudes, subjective norms and perceived behavioural control) and help-seeking intentions. They reported actual help-seeking from mental health professionals via telephone surveys 3 and 6 months later. To better understand the potential gap between help-seeking intentions and behaviour and to investigate the contributions of readiness, willingness and ability to seek help, two path models were constructed in accordance with the TPB controlling for covariates. Attitudes (β = .24), subjective norms (β = .25) and self-efficacy (β = .15) were significantly associated with intentions (R2 = 26%), which predicted help-seeking (Cox and Snell’s pseudo-R2 = 23%); controllability did not predict help-seeking. In sum, the TPB provides a reliable framework to explore help-seeking behaviour for mental health problems. Based on these findings, prevention efforts should focus on readiness and willingness to seek help (e.g. foster positive attitudes and social support of treatment). However, the role of ability, operationalised as perceived behavioural control and (perceived) barriers to help-seeking, warrants further research, as self-efficacy but not controllability was associated with help-seeking.

This paper presents a model predictive control (MPC)-based algorithm for rollover prevention of an autonomous electric road sweeper (AERS). For AERS, the basic function of autonomous driving is a path- and velocity-tracking control needed to make a vehicle follow given path and velocity profiles. On the other, the AERS adopts an articulated frame steering (AFS) mechanism which can make cornering behavior agile. Moreover, the tread of the AERS is narrow, and the height of the mass center is high. As a result, it is prone to roll over. For this reason, it is necessary to design a controller for path and velocity tracking and rollover prevention in order to improve maneuverability and roll safety of the AERS. A kinematic model was adopted as a vehicle one for the AERS. With the vehicle model, reference states of position and velocity were determined that are needed to make the AERS track the reference path and prevent rollover. With the vehicle model and reference states, an MPC-based motion controller was designed to optimize articulation angle and velocity commands. The load-transfer ratio (LTR) was used to measure a rollover propensity. To evaluate the proposed algorithm, a simulation was conducted for the U-turn scenario. Simulation results show that the proposed algorithm improves path tracking and prevents the rollover of the AERS.